Provider Demographics
NPI:1417658071
Name:STANDFAST HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:STANDFAST HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:OMO-OJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-854-6594
Mailing Address - Street 1:7206 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7702
Mailing Address - Country:US
Mailing Address - Phone:443-854-6594
Mailing Address - Fax:
Practice Address - Street 1:7206 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-7702
Practice Address - Country:US
Practice Address - Phone:443-854-6594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care